High Cholesterol

High cholesterol is also called hypercholesterolemia. Cholesterol and dietary fat are not the same thing. But, it’s important to understand how the fat in your diet affects your cholesterol level.

Your body needs cholesterol to build new cells and make certain hormones. There are 2 kinds of cholesterol in your body:

  • HDL (“good”) cholesterol stops fatty deposits (plaque) from building up in your arteries. In this way it protects you against heart disease and stroke.

  • LDL (“bad”) cholesterol stays in your body and sticks to artery walls. It may later block blood flow to your heart and brain. This can cause a heart attack (acute myocardial infarction) or stroke.

Your body makes all the cholesterol it needs. But you also get cholesterol from many of the foods you eat. This is why you want to limit how much cholesterol you get in your diet  and how much fat you eat. That’s because the cholesterol your body makes from the fat you eat creates the most risk for disease. The type of fat you eat has the biggest influence on how much cholesterol your body makes. 

Fats come in 2 kinds:

  • Good fats are the unsaturated fats. These are also called monounsaturated and polyunsaturated fats. They raise the level of good cholesterol and lower the level of bad cholesterol. Good fats are found in vegetable oils like olive, sunflower, corn, and soybean oils, and in nuts and seeds.

  • Bad fats are saturated fats and trans fats. These raise the risk for disease. They lower the good cholesterol and raise the level of bad cholesterol. Bad fats are found in all red meat and whole-milk dairy products. Some plants also have a lot of saturated fats such as coconut and palm plants. Trans fats are found in stick margarines and many fast foods and commercially baked goods. Soft margarine sold in tubs has less trans fat and is safer to use. Trans fat in particular raise bad cholesterol and lowers good cholesterol.

You can have high blood cholesterol if you eat a diet high in saturated fat and don’t get much exercise. In some cases, your family history plays a role. Your health care provider can diagnose high cholesterol with blood tests. Treatment consists of a diet low in saturated fat, weight loss, and exercise. If these efforts don’t lower your cholesterol, your provider may prescribe medicines. They must be taken daily to keep your cholesterol levels low. Being overweight also raises the risk for high cholesterol and heart disease. Losing even a small amount of weight can help lower your risk.

High risk groups

Certain groups of people should talk to their healthcare provider about using cholesterol-lowering statin medicines for controlling their cholesterol to stay healthy or to prevent future heart attacks or stroke. It may be beneficial to take a medicine in addition to eating a healthy diet and exercising regularly for these groups. The major groups include:

  • Adults who have had a heart attack or stroke or some other atherosclerotic disease (such as peripheral vascular disease), a transient ischemic attack, stable or unstable angina, and anyone who has had a procedure to restore blood flow through a blocked artery such as percutaneous coronary intervention, angioplasty, stent, open-heart bypass surgery.

  • Adults who have diabetes or an elevated calculated risk of having a heart attack or stroke (7.5%) and an elevated level of LDL cholesterol 70-189 mg/dL.

  • People who are 21 years of age and older who have an elevated LDL cholesterol level of 190 mg/dL or higher

Home care

Follow these guidelines when caring for yourself at home:

  • Talk with your health care provider before starting a low-cholesterol diet or weight-loss program.

  • In general, a low-cholesterol diet means that you eat less saturated fat (red meat and regular dairy) and less cholesterol each day. You may eat foods with unsaturated fats (vegetable oils, nuts, and seeds). Eat more fruits, vegetables, fish, and whole grains, or other high-fiber foods.

  • Learn to read food labels so you know what you are eating.

  • A registered dietitian can teach you how to plan meals and change your diet. You can ask your provider for a referral.

  • Aim for 40 minutes of moderate to vigorous physical activity 3 to 4 times a week. Pick activities you enjoy. Walking is a good choice if you want to lose weight. If you have diabetes, hypertension, or heart disease, talk with your provider to see what activities he or she recommends.

  • If your provider has prescribed medicines, take them as directed.

  • If you smoke, talk with your provider about how to quit smoking. Smoking lowers good cholesterol levels and can increase damage done by bad cholesterol.

  • Limit how much alcohol you drink.

  • If you have diabetes, talk with your provider and a dietitian about other food and lifestyle changes you can make to lower your risk for heart disease and stroke.

Follow-up care

Follow up with your healthcare provider, or as advised. It takes at least 3 months for dietary changes to show a result in your blood cholesterol. Have repeat blood testing as advised by your provider.

If an X-ray or ECG (electrocardiogram) was done, a specialist will look at it. You will be told of any new findings that may affect your care.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Chest, arm, shoulder, neck, or upper back pain

  • Shortness of breath

  • Weakness or numbness of an arm, leg, or one side of the face

  • Trouble with speech or vision

  • Weakness, dizziness, or fainting

Talk to your healthcare provider about your treatment goals. Make sure you understand how cholesterol impacts you based on your personal health history and family history of heart disease or high cholesterol. Plan to have regular monitoring and follow up on any side effects that you may develop to the cholesterol-lowering medicines. Be aware that sometimes you may need more than one medicine to reach your cholesterol goals. Also make sure you understand how to prepare for your cholesterol testing which may or may not require fasting.